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BERNARDO DERMATOLOGY MEDICAL GROUP INC
NPI 1407950785
Dermatology in Poway, CA

Active since September 08, 2006CLIA 05D0664519 · Certificate of Compliance
15525 POMERADO RD, SUITE A2, POWAY, CA 92064(858) 451-3311(858) 451-1142 Get Directions Write a Review

NPPES record last updated: November 6, 2007. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Bernardo Dermatology Medical Group Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BERNARDO DERMATOLOGY MEDICAL GROUP INC (NPI 1407950785) is a healthcare organization registered as a dermatology in Poway, California and active in the NPI registry since September 2006. The organization holds a CLIA Certificate of Compliance certificate valid through August 28, 2027 and lists Ruth Ann Larson, President, as its authorized official.

NPPES Registry Identity

NPI1407950785
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameBERNARDO DERMATOLOGY MEDICAL GROUP INC
Location Address15525 POMERADO RD, SUITE A2Poway, CA 92064-2435
Mailing Address15525 Pomerado Rd, Suite A2Poway, CA 92064-2435 · (858) 451-3311 · Fax (858) 451-1142
Phone(858) 451-3311
Fax(858) 451-1142
Organization SubpartNo
Authorized OfficialRuth Ann LarsonPresident · (858) 451-3311
Enumeration DateSeptember 8, 2006
Last NPPES UpdateNovember 6, 2007
✔ NPI 1407950785 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
License✔ Licensed in CA · G41388
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
Also ListedDermatology · MOHS-Micrographic SurgeryTaxonomy 207ND0101X · License G41388 (CA)
Also ListedDermatology · DermatopathologyTaxonomy 207ND0900X · License G49647 (CA)
15525 POMERADO RD, Poway, CA 92064
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Other Identifiers 2

Medicare UPINA48556
Medicare ID-Type UnspecifiedW15248CA

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Bernardo Dermatology Medical Group Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

9

Medicare enrollment records show 9 clinicians reassign Medicare billing to Bernardo Dermatology Medical Group Inc, which bills Medicare for the services they deliver. Of these, 5 practice at this address. They are listed nearest first.

Clinicians, nearest first (9)

Elizabeth Vierra, M.D.
Dermatology
NPI 1669470167
15525 POMERADO RD SUITE A-2
Poway, CA 92064
(858) 451-3311
✔ PECOS✔ Accepts MedicareSame address
Mark Vierra, M.D.
Dermatology
NPI 1730187121
15525 POMERADO RD SUITE A-2
Poway, CA 92064
(858) 451-3311
✔ PECOS✔ Accepts MedicareSame address
Leah Brown, NP
Nurse Practitioner
NPI 1215166202
15525 POMERADO RD SUITE A2
Poway, CA 92064
(858) 451-3311
✔ PECOSSame address
Ruth Larson, M.D.
Dermatology
NPI 1538167911
15525 POMERADO RD SUITE A2
Poway, CA 92064
(858) 451-3311
✔ PECOS✔ Accepts MedicareSame address
Ashley Rubin, M.D.
Dermatology
NPI 1538459870
15525 POMERADO RD STE A2
Poway, CA 92064
(858) 451-3311
✔ PECOS✔ Accepts MedicareSame address
Julie Gladsjo, MD
Dermatology
NPI 1629234380
6195 LUSK BLVD STE 250
San Diego, CA 92121
(858) 859-1188
✔ PECOS✔ Accepts Medicare10 mi
Allison Han, MD
Dermatology
NPI 1316408214
7910 FROST ST STE 120
San Diego, CA 92123
(858) 966-6795
✔ PECOS✔ Accepts Medicare15 mi
Leanna Hansen, MD
Dermatology
NPI 1053948380
101 THE CITY DR S STE 400
Orange, CA 92868
(714) 456-5691
✔ PECOS✔ Accepts Medicare73 mi
Vanessa London, MD, MS
Dermatology
NPI 1023288495
9501 ROOSEVELT BLVD SUITE 508
Philadelphia, PA 19114
(215) 464-7400
✔ PECOS✔ Accepts Medicare2,366 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 05D0664519

Bernardo Dermatology Medical Group · Poway, CA
Active · expires Aug 28, 2027
CLIA Number05D0664519
Laboratory TypeIndependent
Certificate Effective DateAugust 29, 2025
Certificate Expiration DateAugust 28, 2027
Laboratory DirectorDr. Ruth A. Larson MD
Laboratory Phone(858) 451-3311
Laboratory LocationBernardo Dermatology Medical Group15525 Pomerado Rd, Ste A2, Poway, CA 92064
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bernardo Dermatology Medical Group Inc's NPI number?

The NPI number for Bernardo Dermatology Medical Group Inc is 1407950785. It was assigned to this organization in the NPPES registry on September 8, 2006.

Where is Bernardo Dermatology Medical Group Inc located?

Bernardo Dermatology Medical Group Inc is located at 15525 Pomerado Rd Suite A2, Poway, CA 92064. The listed phone number is (858) 451-3311.

What is Bernardo Dermatology Medical Group Inc's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Is Bernardo Dermatology Medical Group Inc enrolled in Medicare?

Yes. Bernardo Dermatology Medical Group Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Bernardo Dermatology Medical Group Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 9 clinicians in 2 Medicare specialties reassign their Medicare billing to Bernardo Dermatology Medical Group Inc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Dermatology (8) and Nurse Practitioner (1). Of these, 5 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Bernardo Dermatology Medical Group Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 05D0664519) is associated with this NPI, valid through August 28, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Bernardo Dermatology Medical Group Inc was last updated on November 6, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.